产后性问题与产后保健服务

Women's Sexual Health after Childbirth and Postpartum Health Care

目的 :了解产后各种不同类型性问题的发生率以及在产后保健服务中对性健康重视的状况。方法 :采用横断面研究方法 ,将分娩活婴的 4 6 0例初产妇产科住院记录和产后 6月门诊随访问卷调查所得资料进行分析。结果 :94 74 %初产妇于产后 6月内恢复性生活 ,但妇女性问题的发生率较产前明显增加。其中 ,产后 3月内 70 5 9%存在性问题 ,产后 3～ 6月内下降为 6 4 0 8% ,产后 6月时 ,降至 34 17% ,但未恢复到妊娠前 (7 17% )的水平。产后常见的女性性问题有 :性交疼痛、阴道干涩、性高潮障碍、阴道松弛等 ;其中 ,性交疼痛发生率占第 1位 ,产后 3月内为 6 1 76 % ,产后 6月为 13 2 1%。产后 4 2天接受产科随访时 ,仅 2 0 82 %的妇女从卫生保健人员得到有关的性健康知识。在有产后性问题的妇女中 ,与卫生保健人员讨论过该问题者仅为 8 0 2 %。结论 :产后性健康问题非常普遍 ,但产后保健服务中性健康未得到应有重视 ,缺乏专业人员提供咨询与治疗。提示对产后性问题的咨询与治疗的潜在需求极大 ,值得重视。

Objective: To investigate the impact of childbirth on the sexual health of primiparous women in China,and to understand the incidence of women's sexual problems after childbirth, its common types,and the situation of postnatal care services on thought highly of sexual life. Methods: We inquired 460 of primiparous women delivering of a live birth at the First Affiliated Hospital of Chongqing Medical University between November 1,2000 and July 31,2001. It was a cross-sectional study using obstetric records and postal questionnaire survey by outpatient consultation six months after delivery. Results: 94.74% had resumed sexual activity within six months of labor. The morbidity of sexual problems increased significantly after labor:in the first three months after delivery,70.5% of women experienced sexual problems,then declining to 55.63% between three months and six months,and 34.17% at six months,not reaching to prenatal 7.17%. Dyspareunia and lack of vaginal lubrication were common experiences for postnatal women. Among them,dyspareunia was the most common type. 61.76% of women had experienced dyspareunia in the first three months after labor and 13.21% at six months. Only 20.82% of women received information about sexual health,rate of consultation for problems with heath provider about sexual problems was 8.02%. Conclusions: Sexual health problems after childbirth were very common, suggesting potentially high levels of unmet need which postnatal care services do not currently address.